[Surgery of lung tumors]

Indeterminate solitary pulmonary nodules deserve prompt histologic confirmation, which is easily and efficiently achieved by thoracoscopic wedge resection. Patients with stage I to IIIa NSCLC are best treated by complete tumor resection (lobectomy/pneumonectomy) and mediastinal lymph node dissection. However, induction (radio)chemotherapy followed by surgical resection is increasingly performed for locally advanced NSCLC, since this offers far better results than surgery or radiotherapy per se, especially for bulky N2 disease. Surgical resection of pulmonary metastases is certainly indicated in selected patients, and the outcome is strongly related to the completeness of tumor removal. Patients with peripheral solitary lung metastases are increasingly treated by thoracoscopic wedge resection, followed by CT-scans at regular intervals.